Beriberi: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Beriberi?
A primary care doctor or an internist, a doctor who treats adults, usually diagnoses and treats beriberi. A neurologist or heart doctor may help with nerve or heart problems. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is beriberi?
Beriberi is a disease in which the body does not have enough thiamine, also called vitamin B1. If you eat a normal, healthy diet, you should get enough thiamine. Beriberi is rare in the United States.
There are two major types. Wet beriberi affects the cardiovascular system, the heart and blood vessels. Dry beriberi affects the nervous system, the brain, spinal cord, and nerves. Untreated, beriberi can be fatal. With treatment, symptoms usually improve quickly.
Symptoms
Symptoms of dry beriberi include:
- Tingling or loss of feeling in the hands and feet.
- Loss of muscle function or paralysis of the lower legs.
- Difficulty walking.
- Pain, vomiting, or mental confusion.
- Speech difficulties.
- Strange eye movements, called nystagmus.
Symptoms of wet beriberi include waking at night short of breath, shortness of breath with activity, a faster heart rate, and swelling of the lower legs.
If the deficiency lasts a long time, a person can develop Wernicke-Korsakoff syndrome, a brain problem caused by thiamine deficiency. Early signs can include gait problems and eye-movement problems. If it is not treated, it can turn into Korsakoff psychosis. That brings severe short-term memory loss, disorientation, and hallucinations.
Causes and who gets it
Beriberi is rare in the United States because many foods are now vitamin enriched. A normal, healthy diet gives most people enough thiamine. Today it happens mostly in people who drink too much alcohol. Heavy drinking leads to poor nutrition and makes it harder for the body to absorb and store vitamin B1.
Other risk factors include diabetes, older age, hyperthyroidism, an overactive thyroid gland, pregnancy, and vomiting that will not stop. Other risk factors also include surgery on the stomach or gut, AIDS, gut diseases, kidney failure with dialysis, and long-term use of water pills called diuretics. Dialysis is a treatment that filters the blood. In rare cases, beriberi is genetic and runs in families. People with that form slowly lose the ability to absorb thiamine from food. Infants can get beriberi if they are breastfed by a mother low in thiamine or fed a formula without enough of it.
How doctors diagnose it
A physical exam may show signs of heart failure. These include an enlarged heart, rapid heartbeat, fluid in the lungs, and swelling in both lower legs. A neurological exam may show changes in walking, coordination problems, decreased reflexes, or drooping eyelids. In late-stage beriberi, a person may be confused or have memory loss and delusions. Blood tests can measure the amount of thiamine in the blood. Urine tests can show if thiamine is passing through the urine. A blood thiamine level is not always a reliable sign of the body's thiamine stores. However, another blood test, called erythrocyte transketolase activity, can measure how thiamine works in the body.
Treatment
The goal of treatment is to replace the thiamine the body is lacking. This is done with thiamine supplements. They are given through a shot or taken by mouth. The provider may suggest other vitamins too. Blood tests may be repeated after treatment starts. These show how well the body responds. Heart damage is usually reversible, and a full recovery is expected in those cases. Nerve damage is also reversible if caught early. If it is caught late, some problems, such as memory loss or confusion, may remain even with treatment.
When to see a doctor
Contact a doctor if you or your children have any symptoms of beriberi. Also contact a doctor if your family's diet seems poorly balanced. Get care right away if you have symptoms of beriberi, because untreated beriberi can be fatal. Call 911 for trouble breathing, chest pain that lasts two minutes or more, fainting, or new confusion. See a doctor right away for a racing heart, swollen legs, or trouble walking. Untreated beriberi can lead to coma, heart failure, or death.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your diet and risk factors, arrange thiamine testing and treatment, and coordinate follow-up with a dietitian or specialists.
Common questions
What foods have thiamine?
Brown rice, whole grains, pork, poultry, soybeans, nuts, peas, dried beans, and fortified or enriched grain products such as breads and cereals are rich sources of thiamine.
How is beriberi treated?
With thiamine supplements, given through a shot or taken by mouth. The goal is to replace the thiamine the body is lacking. Other vitamins may be suggested, and blood tests are repeated to track recovery.
Can beriberi be prevented?
Yes. Eating a proper diet rich in vitamins will prevent it. Nursing mothers should eat a complete diet, and infant formula should contain thiamine. Cutting down heavy drinking also helps.
Do symptoms get better with treatment?
Yes, for most people. Symptoms usually improve quickly with treatment, and heart damage is usually reversible. Nerve damage can leave lasting problems, such as memory loss, if it is caught late.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
